胸部电阻断层扫描和肺部超声波估计的肺部通风在输出管过程中
Vincent Joussellin1,2, Vincent Bonny1,2, Savino Spadaro3
1Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.
Annals of intensive care
|September 26, 2023
概括
患有输出失败风险的患者显示肺气化减少和通风异质性增加,可通过胸部电阻断层扫描 (EIT) 和肺超声波 (LUS) 检测. 这些发现有助于预测输出管的结果.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 医疗成像医学成像
背景情况:
- 输出失败是重症监护中的一个重要问题.
- 患有输出管失败风险的患者可能表现出肺空气和通风分布受损.
- 胸部电阻断层扫描 (EIT) 和肺部超声波 (LUS) 是监测肺功能的潜在工具.
研究的目的:
- 调查输出失败是否与肺空气流失和异质空气分布有关.
- 为了确定胸部EIT和LUS是否可以监测患有脱口失败风险的患者的这些变化.
主要方法:
- 一项前性研究,包括在自发呼吸试验后面临脱口失败风险的患者.
- 肺部超声波 (LUS) 和胸部EIT是在输出管之前 (H0) 和输出管后2 (H2) 和6 (H6) 小时进行的.
- 从EIT衍生出的指数 (全球不均指数,通风中心,区域通风延迟,可供通风的表面) 和LUS在成功输出和输出失败组之间进行了比较.
主要成果:
- 40名患者中有12名 (30%) 经历了输出失败.
- 在输出管之前,失败的患者的LUS较高,空气可供通风的面积较小,与成功患者相比.
- 输出管后,输出管失败组显示出更高的全球不均质指数和LUS,以及可供通风的表面较低.
结论:
- 肺空气的损失之前的输出失败.
- 这种空气损失在输出管后仍然存在,并且与区域通风异质性有关.
- 胸部EIT和LUS可以通过检测肺空气和通风异常来识别患有输出失败风险的患者.
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